Mapping immunosuppressive terrain in high-grade serous ovarian cancer: tumor-intrinsic, stromal, and spatial drivers of therapy response

High-grade serous ovarian cancer (HGSOC) features a profoundly immunosuppressive tumor microenvironment (TME) that limits immunotherapy. Yet resistance is multilayered and spatially heterogeneous without an integrated framework. This review synthesizes recent advances that map multifaceted immune resistance in HGSOC across tumor-intrinsic, stromal, and spatial dimensions. Furthermore, we discuss potential translational strategies of remodeling the TME, with the goal of offering a context-aware roadmap for rational combination immunotherapy.